Oxidative stress and bone resorption interplay as a possible trigger for postmenopausal osteoporosis.

The underlying mechanism in postmenopausal osteoporosis (PO) is an imbalance between bone resorption and formation. This study was conducted to investigate whether oxidative stress (OxS) might have a role in this derangement of bone homeostasis. In a sample of 167 postmenopausal women, we found that increased serum levels of a lipid peroxidation marker, hydroperoxides, were negatively and independently associated with decreased bone mineral density (BMD) in total body (r = -0.192, P < 0.05), lumbar spine (r = -0.282, P < 0.01), and total hip (r = -0.282, P < 0.05), as well as with increased bone resorption rate (r = 0.233, P < 0.05), as assessed by the serum concentration of C-terminal telopeptide of type I collagen (CTX-1). On the contrary, the OxS marker failed to be correlated with the serum levels of bone-specific alkaline phosphatase (BAP), that is, elective marker of bone formation. Importantly, multiple regression analysis revealed that hydroperoxides is a determinant factor for the statistical association between lumbar spine BMD and CTX-1 levels. Taken together, our data suggest that OxS might mediate, by enhancing bone resorption, the uncoupling of bone turnover that underlies PO development.

Waist circumference and dual-energy X-ray absorptiometry measures of overall and central obesity are similarly associated with systemic oxidative stress in women.

Growing evidence suggests that overall and abdominal obesity might lead to oxidative stress (OxS), which, in turn, plays a key role in the pathogenesis of a wide spectrum of diseases. In this study, for the first time, we compared the correlations of indirect, i.e. anthropometric, and direct, by dual energy X-ray absorptiometry (DXA), measures of body fat with circulatory OxS markers in women. To address this issue, we assessed central and total body fat mass (FM) by DXA, and serum levels of advanced oxidation protein products (AOPP), thiols and hydroperoxides in 275 healthy women (age 21-65 years; body mass index [BMI] 21.1-32.0 kg/m(2); waist circumference [WC] 60.1-109.9 cm). Among the markers considered in the study, only hydroperoxides levels, i.e. by-products of lipid peroxidation, were significantly (p < 0.05 for all) and positively correlated to body fat accumulation after controlling for confounding factors. In particular, this marker was found to be similarly associated with DXA-derived total FM, total FM % and trunk FM as well as with WC. Of note, hydroperoxides appeared to be correlated with abdominal but not with general obesity, as classified according to standard WC and BMI cut-offs, respectively. In conclusion, taken together our data demonstrated that, at least in women, the measurement of body FM by DXA has no advantage over the simpler and cheaper WC with regard to their associations with systemic OxS markers. Moreover, WC emerged as a superior potential predictor of OxS compared to the other most commonly used anthropometric measures (including BMI and waist to hip ratio).

Accuracy of ultrasonography in the diagnosis of acute appendicitis in adult patients: review of the literature.

BACKGROUND: Ultrasound is a widely used technique in the diagnosis of acute appendicitis; nevertheless, its utilization still remains controversial. METHODS: The accuracy of the Ultrasound technique in the diagnosis of acute appendicitis in the adult patient, as shown in the literature, was searched for. RESULTS: The gold standard for the diagnosis of appendicitis still remains pathologic confirmation after appendectomy. In the published literature, graded-compression Ultrasound has shown an extremely variable diagnostic accuracy in the diagnosis of acute appendicitis (sensitivity range from 44% to 100%; specificity range from 47% to 99% ). This is due to many reasons, including lack of operator skill, increased bowel gas content, obesity, anatomic variants, and limitations to explore patients with previuos laparotomies. CONCLUSIONS: Graded-compression Ultrasound still remains our first-line method in patients referred with clinically suspected acute appendicitis: nevertheless, due to variable diagnostic accuracy, individual skill is requested not only to perform a successful exam, but also in order to triage those equivocal cases that, subsequently, will have to undergo assessment by means of Computed Tomography.

Contrast enhanced ultrasound (CEUS) in blunt abdominal trauma.

In the assessment of polytrauma patient, an accurate diagnostic study protocol with high sensitivity and specificity is necessary. Computed Tomography (CT) is the standard reference in the emergency for evaluating the patients with abdominal trauma. Ultrasonography (US) has a high sensitivity in detecting free fluid in the peritoneum, but it does not show as much sensitivity for traumatic parenchymal lesions. The use of Contrast-Enhanced Ultrasound (CEUS) improves the accuracy of the method in the diagnosis and assessment of the extent of parenchymal lesions. Although the CEUS is not feasible as a method of first level in the diagnosis and management of the polytrauma patient, it can be used in the follow-up of traumatic injuries of abdominal parenchymal organs (liver, spleen and kidneys), especially in young people or children.